Funding Awarded

In Multiple Sclerosis Interferonb has been used as a first line treatment regimen for the past 15 years and many patients have shown therapeutic benefit and continue to do so from this 'natural' immune modulator. However, for others interferonb shows no clear therapeutic benefit and we are looking into how to change these patients into...

Cardiovascular disease (CVD) is a major cause of death for Irish people killing 1 in 3 every year. Most of the problems associated with CVD are due to changes in the structural integrity of the blood vessel wall resulting in obstruction of blood flow that can lead to a heart attack or stroke. Key cells involved in this blockage are...

Staphylococcus aureus is a bacterium that frequently causes serious infections among hospitalised patients. This includes methicillin-susceptible S. aureus (MSSA) that are readily treatable with antibiotics and the so-called antibiotic resistant "superbug"MRSA (methicillin-resistant S. aureus). MRSA have been widespread in...

People who inject heroin have a risk of death six times higher than the general population. The most effective treatment for heroin injectors is the prescription of legal, substitution drugs, most commonly methadone. This is called opiate or methadone substitution treatment (MST). The majority (60%) of patients on MST in Ireland attend...

A pathologists' task in assessing a prostate biopsy for cancerous tissue is of prime importance since failure to correctly identify tissue can lead to a failure to accurately diagnose the patient and predict their likely prognosis. Histological staining assists in the assessment of prostate biopsies by making important features of the...

Approximately 5-10% of hospitalised patients acquire an infection in hospital. Serious infections are more likely in intensive care unit (ICU) or high dependency unit (HDU) patients, in whom implanted medical devices are required for life maintaining therapy. Unfortunately such devices also represent an opportunity for pathogens such...

Generalised anxiety disorder (GAD) is a chronic and debilitating anxiety disorder characterised by excessive worry, anxiety, and somatic symptoms such as tiredness. It is often found alongside other disorders such as depression. Its main features are also important for our understanding of the other anxiety disorders. Alongside...

Patients and clinicians are faced with the dilemmas associated with the detection and treatment of Prostate cancer. One such dilemma is in the early stages of diagnosis when men are referred by their GP for suspicion of prostate cancer but it is not clear if they need a biopsy or not. This is because PSA in not specific for prostate...

In Ireland we ask society or the general public to state their preferences for descriptions of health. We then use these valuations or preferences to calculate the impact of technologies on quality of life and this informs how decision makers decide what to fund. This is known as the QALY framework and is used in most jurisdictions to...

Hardly a week goes by without a national media report on the medical staffing crisis in the Irish health services, which is perhaps the biggest current threat to the delivery of quality health services to the population of Ireland. With 6- and 12-monthly staff turnovers, employers are forced to recruit staff from abroad to fill posts...

Schizophrenia has been estimated to affect up to 1 in 100 people in Ireland. Given its prevalence, the underlying causes of the condition are still far from clear. Intriguingly, there exists a chromosomal abnormality termed 22q11 deletion syndrome (22q11DS), where schizophrenia can manifest 20 times more frequently than in the general...

This research project aims to look at the relationship between experiencing stressful life events during childhood and experiencing psychotic-like symptoms (like hearing voices that other people can't hear, for example) in adolescence. Researchers have already shown that there is a relationship between these two experiences but, up...

The causes of both common mental illnesses like anxiety and depression and more severe mental illnesses like schizophrenia and bipolar disorder are still unclear. We know that these illnesses are most likely a complex mix of environmental factors working in conjunction with underlying genetic vulnerability. The genetic input to these...

Schizophrenia is among the most expensive disorders in terms of quality of life and societal cost. While treatments are inadequate, early intervention has been shown to be clinically effective. Consequently, there is an urgent need to improve our understanding of the pathophysiology of this disorder so that we can identify and treat...

Idiopathic pulmonary fibrosis (IPF) is a lung disease of unknown cause which leads to excessive scarring of the lungs, resulting in loss of lung function, respiratory failure and ultimately, death. IPF is believed to be caused by abnormal repair of the lung after a chronic injury by an unknown agent to the lining of the lung (the...

Cancer of the oesophagus, or food pipe, is an aggressive type of cancer with poor outlook and is affecting a growing number of people. The main types of treatments are surgery, chemotherapy and radiotherapy, which may be given alone or in combination. Although chemoradiotherapy treatments work well for some, the majority of patients...

Epilepsy is the most common life-long brain disease and its diagnosis remains challenging needing the application of multiple criteria including patient history, seizure type and electroencephalography (EEG) recordings. The most reliable method is long periods under video surveillance during continuous EEG monitoring which is costly...

Multiple mutations in over 200 genes can cause retinal degeneration, a group of diseases that result in the death of light detecting photoreceptor cells in the retina. Mutations in more than 30 genes can also cause optic neuropathies, a group of disorders that affect retinal ganglion cells, causing the optic nerve to be less capable of...

During the treatment and management of disease important clinical decisions are made, including deciding whether a patient has a particular illness and whether they may benefit from a specific treatment. These decisions are often made with the assistance of information from different measurements including patient details, scans,...

Rheumatoid arthritis (RA) is a form of inflammatory arthritis that affects approximately 45,000 people in Ireland and bears a high personal, social and economic cost. It is estimated that the cost of treating patients with RA in Ireland is approximately

Hepatitis C virus (HCV) infects over 170 million people in the world. Most individuals go on to develop a chronic lifetime infection that is associated with progressive liver disease. While new drugs have recently been developed, they are very expensive and are not a treatment option for developing countries. In addition, there are...

Hormonal, reproductive, and dietary factors play an important role in the aetiology of breast cancer (BC). Selenium (Se) is an essential micronutrient thought to aid cancer prevention via its incorporation into selenoproteins which help counter oxidative damage to DNA, proteins, and lipids. Such DNA damage also appears to play a...

Almost one third of the world's population is infected with Mycobacterium tuberculosis (Mtb) with almost 2 million deaths to tuberculosis (TB) annually. Over 400 patients are treated for active TB annually in Ireland, with an increasing number of drug-resistant cases emerging. Currently treatment involves a multi-drug course for 6...

Pre-eclampsia, a serious condition of late pregnancy, characterised by high blood pressure and proteinuria in the second-half of pregnancy, affects 5% of first time mothers and is associated with significant maternal and neonatal morbidity and mortality. A quarter of babies born to women with pre-eclampsia do not grow properly, and a...

Poor Type 1 Diabetes (T1D) self-care results in poor metabolic control and is particularly challenging during adolescent years. Good metabolic control of T1D is important to prevent long-term negative outcomes. With parents holding a central role in creating a safe learning environment and motivating adolescents to monitor food intake,...

This project will advance current knowledge about communication difficulties in children with spina bifida and hydrocephalus (SBH). This condition affects the normal development of the spinal cord and brain and is particularly relevant to the Irish context because of the high incidence in the country - currently at least 500 children...

Crescentic glomerulonephritis (CGN) is a severe form of kidney failure that leaves about one third of sufferers dependent on dialysis or needing a kidney transplant. It is currently difficult to assess the condition without performing a kidney biopsy, which is uncomfortable, expensive and occasionally dangerous to the patient. We have...

International evidence shows that minority ethnic groups have poorer health and more difficulties accessing healthcare than majority ethnic groups. Analysis of existing health datasets and the use of ethnic identifiers in health care systems are promoted internationally as valuable ways to address these differences. It is not possible...

Each cancer patient has a unique response to cancer treatments such as chemotherapy and radiotherapy. An individual patients response to cancer treatment is to a significant degree determined by their own biology (genetic profile) and other environmental factors such as diet and lifestyle. With the evolution of technologies such as...

Neonatal brain injury has a many causes and may result in cerebral palsy. Cooling therapy is the only established treatment but 50% of babies treated will die or have disability and so new therapies to reduce brain injury are urgently needed. New-borns who are severely affected also have problems with their heart, liver, lung and...

Communication between physician and patient is crucial to the overall quality of primary care. An important element of this interaction is the physician-patient interview. While there are various opinions on what constitutes effective communication in a medical interview, sometimes supported by formal (qualitative and quantitative)...

Approximately 30,000-50,000 people in Ireland have hepatitis C. Although the virus mainly affects the liver, in up to 30% of infected people the virus also affects the brain causing poor concentration, difficulties in concentrating, poor memory. Patients often describe this as a "brain fog". These symptoms may lead to...

Healthcare Associated Infections (HCAIs) such as Methicillin-resistant Staphylococcus Aureus (MRSA) represent the most frequent complications experienced by hospital patients. Effective hand hygiene practices are considered to be the most important strategy for preventing HCAIs. However, compliance with good hand hygiene practices has...

Depression is the most common psychiatric disorder in the world, accounting for approximately 90% of deaths by suicide. Rates of depression are rising alarmingly in the OECD countries. Although depression is considered to be a single clinical disorder, it has many underlying causes ranging from childhood abuse through to purely genetic...

Systemic sepsis is a severe condition arising from a bacterial or fungal infection of the blood or lymph. It commonly leads to overwhelming inflammation and multiple organ failure and can kill up to 50% of sufferers. Toxins produced by bacteria are the major trigger for these responses in the patient. There are currently no specific...

Hirschsprung's disease (HD) is a relatively common cause of intestinal obstruction in the new-born, occurring in 1 in 4,000 live births. It is characterised by abnormal development of the nerve supply to varying lengths of the large bowel prior to birth. The gold standard treatment for HD is an operation to remove the diseased bowel...

Many patients that suffer from cancer of the colon require chemotherapy. Chemotherapy is supposed to induce the death of cancer cells by a molecularly controlled death process called apoptosis. Apoptosis in response to chemotherapy requires the activation of cell death genes, but colon cancer cells often can prevent these genes from...

Clinical dementia, the majority of cases being caused by Alzheimer's disease, seriously impairs the lives of over 50 million people worldwide currently (costing ~1% of the aggregated global gross domestic product). There are approximately 48,000 people with dementia and 50,000 dementia carers in Ireland. At present the lifetime risk...

This project will examine several aspects of traumatic spinal cord injury in the Irish population. The project will look backwards (retrospective) and forwards (prospective). For the years 2010 - 2014 inclusive, the medical records of all patients with traumatic spinal cord injury discharged from the National Rehabilitation Hospital...

Stroke is usually caused by the occlusion of a brain artery with a clot. It is the third most common cause of death and the most common cause of acquired physical disability in Ireland. The only available drug is only used in ~5% of patients (because most patients are either too far, or arrive too late to a specialized treatment...

Smoking is the single biggest preventable cause of death in Ireland. There are many reasons why someone might remain addicted to nicotine and many factors affecting each individual's response to withdrawal. For example, socioeconomic status, gender or life stress can all play a role. Ultimately, nicotine has its effects by altering...

Clinical Research Facilities and Centres (CRF/Cs) have been developed in each of the five applicant universities, providing the infrastructure and specialist staff to facilitate collaborative research but they lack an overarching support structure with which to coordinate multicentre clinical trial activities. One key exception is...

The principle of equal treatment for equal need is a key component of health policy. However, Irish and international evidence shows that factors other than health need are important in determining healthcare use. For example, there is extensive evidence that those who must pay for general practitioner (GP) care have fewer visits than...

Vesicoureteric reflux (VUR) is the backflow of urine from the bladder towards the kidneys. It is a common disorder in children, but is often not diagnosed because it may have no symptoms. In some children, it stops happening as they grow, and they suffer no ill effects. However, it can be associated with kidney damage, and is a major...

Sexual problems are particularly common among people with cardiovascular disease, and have been shown to negatively impact quality of life, psychological wellbeing (anxiety and depression) and relationship satisfaction.

The age structure of the population in Ireland is changing rapidly and the HSE predicts that the 65+ year old age group will contribute 20% of the population by the year 2036. Already, nearly 5% of the population are engaged as caregivers for ill elderly relatives and this is particularly stressful for those whose spouses or parents...

Alzheimers disease (AD) represents one of the major brain illnesses that we now face. Treatments against this disease are limited and offer little in terms of cure. With the global population age now rising, AD is suggested to affect 1 in every 3 people. If left untreated, AD has potential to bring about collapse in healthcare,...

Psoriasis is a chronic inflammatory skin disease that causes cells to build up rapidly on the surface of the skin, forming thick silvery scales that become itchy, dry and sometimes painful. Current treatments for psoriasis depend on disease severity and include topical ointments, light therapy and systemic medications which are...

Most patients who present with problem drinking also present with mood problems. Problem drinking and mood problems co-occurring together in individuals lead them to have more severe symptoms, greater disability and poorer quality of life than individuals with only problem drinking, and they pose a greater economic burden to society...

Still less than one third of patients with MDD achieve remission with an adequate trial of a standard antidepressant after 10 - 14 weeks of treatment. This project will provide a crucial part of the research required for the development of more effective therapy strategies and for understanding the backgrounds for achieving remission...

With 35 million people currently leaving with HIV and 1.6 million people worldwide who died from HIV in 2012, the AIDS pandemic is a major health crisis. In Ireland, the HSE and the HSPC have made HIV/AIDS a notifiable disease and a major public health importance. 30 years of intense HIV/AIDS research have provided efficient...

Although breast cancer surgery and treatment have greatly improved in recent years, certain types of tumours are much more aggressive than others and therefore represent a greater risk to the patient. One such type of breast tumour is identified by the fact that it has high levels of a specific tumour marker called HER2. Therapies...

The treatments used to cure cancer of the oesophagus (food pipe) are usually twofold. Patients may first receive chemotherapy (drug treatment) to shrink the cancer followed by surgery to remove the oesophagus from the body. Patients who undergo this treatment for oesophageal cancer experience a number of weakening side-effects which...

High blood pressure (hypertension) is known to cause brain ageing, from memory problems through to frank dementia, and is common in older age, affecting 70% of people over 70 years of age. Low blood pressure (hypotension) may be an even greater risk factor for cognitive decline and dementia; as it is an easily treatable condition this...

Currently there is no efficient method of continuously measuring oxygen or pH in real-time in hospitals. Existing techniques suffer from slow, indirect recordings and require the undesirable removal of a blood sample from patients. Doctors are extremely interested in measuring both of these parameters since they provide important...

Depression affects up to 20% of people in their lifetime and can be a severe debilitating illness. Indeed, the World Health Organisation has estimated that depression will soon be the second leading contributor to the burden of disease worldwide. One of the big problems for patients and doctors is that currently available...

Helicobacter pylori infection is a public health issue. It remains one of the most common infections in adults in Ireland (22%) and is associated with significant morbidity and mortality as the primary cause of stomach ulcers and stomach cancers. Infection is more common in lower socioeconomic groups and increases with age. Despite...

It is essential that nursing home staff are equipped to provide high-quality end-of-life care, while it is also essential that the wishes of the older person about their care are taken into account. Many nursing home residents develop dementia, which can interfere with their ability to make healthcare decisions and to communicate...

Rheumatoid Arthritis (RA) is a chronic inflammatory disease affecting 1-2% of the population. Over time, RA causes joint destruction, chronic pain and lifelong disability. In addition to these effects, increased resistance to the effects of insulin and alterations in glucose handling mimicking effects seen in type II diabetes occur in...

High blood pressure causes, or helps to cause, almost two-thirds of all strokes and half of all heart attacks. Most people with high blood pressure can be treated by changing what they eat, doing more exercise or taking medications. However, among people with high blood pressure are some whose blood pressure remains too high despite...

Tissue engineering is an emerging field of medicine that aims to treat diseased or damaged tissue through regeneration, rather than replacement. In order to achieve this, implantable scaffolds, that act as templates for tissue formation, are designed so that they not only provide structural support but also provide signals to cells...

Many people grind their teeth at night, and may not be aware of it. Tooth grinding can cause headaches, facial pain or severe damage to the teeth. To prevent these problems, dentists often prescribe a mouthguard to use at night. Mouthguards are effective but few patients use them enough. Patients often wrongly believe that their...

Von Willebrand factor (VWF) is a large plasma protein that plays an essential role in normal blood coagulation. Inherited VWF deficiency is responsible for the commonest inherited bleeding disorder (von Willebrand disease or VWD) that affects up to 1% of the general population. Although substantial progress has been achieved in...

Chronic kidney disease, which affects an estimated 300,000 people in Ireland and over 50 million people in the developed world, is responsible for a considerable burden of premature mortality and morbidity. All patients with chronic kidney disease are recommended low salt diets, i.e. less than a teaspoon of salt per day (which is 5-6g...

Obesity has been shown to cause and worsen diseases such as diabetes, psoriasis, arthritis, asthma and cancer. Increased inflammation is the basic process, which causes obesity related diseases. Inflammation is the body's normal way of dealing with an infection or injury, but is usually specific and short lived. However, in obese...

Cancers of the rectum (the lower part of the large intestine where the body stores stool) are a common cause of cancer-related death in Ireland and cause a significant burden to the quality of life of affected patients. Surgery is the mainstay for the treatment of rectal cancer, but surgeons often prefer to 'downstage' or 'shrink' the...

Despite advances in medicine, pneumonia is still a common disease accounting for 5% of deaths in Ireland and is the most common cause of acute lung injury and acute respiratory distress syndrome where there currently remains no specific therapy. Studies carried out by this and other research groups have recently shown that bone-marrow...

The incidence of Cystic Fibrosis (CF) is very high in Ireland. Survival has improved greatly over the past 30 years. However as longevity has increased so has the development of complications including liver disease. The diagnosis and treatment of liver disease in CF is particularly challenging. We do not understand the cause of liver...

Sepsis accounts for over 18 million deaths annually and is characterised by a severe/hyper activation of the immune system, also referred to as a cytokine storm, which is triggered by infection. In its most severe form sepsis manifests as septic shock and can lead to hypotension and multi-organ failure leading to death. The incidence...

The objective of this study is to provide an understanding of the supply of and interaction between health and social care services delivered in different sectors (acute hospitals: primary and community care; long-term care; informal care at home) in Ireland to inform the Governments policy of transferring activity and resources from...

Acute Kidney Injury (AKI), previously called acute renal failure, occurs when kidney function deteriorates rapidly over hours or days and elevated levels of waste products accumulate in the blood. AKI is most common in people who are hospitalized, particularly in critically ill people who need intensive care. AKI may occur in multiple...

The current Irish Government has committed itself to achieving universal access to health care, free at the point of delivery, by 2016. Yet, at the moment, timely access to essential healthcare in Ireland is often determined by ability to pay, such as with private insurance. Further, those without medical cards or GP visit cards face...

Galactosaemia is an inherited condition caused by a lack of an enzyme (catalyst) which normally breaks down galactose (the sugar found in milk products). This affects on in 16,000 births annually in Ireland (the highest incidence worldwide), and is screened for by the National Newborn Screening Programme. When an affected infant...